教育和情景记忆对大脑萎缩影响认知衰退的修饰作用比较：对认知储备测量的启示。
Comparison of Education and Episodic Memory as Modifiers of Brain Atrophy Effects on Cognitive Decline: Implications for Measuring Cognitive Reserve.
机构信息
Department of Neurology, University of California, Davis, 4860 Y Street, Sacramento, CA95817, USA.
Department of Neurology, University of California, Davis, 1544 Newton Court, Davis, CA95616, USA.
出版信息
J Int Neuropsychol Soc. 2021 May;27(5):401-411. doi: 10.1017/S1355617720001095. Epub 2021 Jan 18.
OBJECTIVE
This study compared the level of education and tests from multiple cognitive domains as proxies for cognitive reserve.
METHOD
The participants were educationally, ethnically, and cognitively diverse older adults enrolled in a longitudinal aging study. We examined independent and interactive effects of education, baseline cognitive scores, and MRI measures of cortical gray matter change on longitudinal cognitive change.
RESULTS
Baseline episodic memory was related to cognitive decline independent of brain and demographic variables and moderated (weakened) the impact of gray matter change. Education moderated (strengthened) the gray matter change effect. Non-memory cognitive measures did not incrementally explain cognitive decline or moderate gray matter change effects.
CONCLUSIONS
Episodic memory showed strong construct validity as a measure of cognitive reserve. Education effects on cognitive decline were dependent upon the rate of atrophy, indicating education effectively measures cognitive reserve only when atrophy rate is low. Results indicate that episodic memory has clinical utility as a predictor of future cognitive decline and better represents the neural basis of cognitive reserve than other cognitive abilities or static proxies like education.
目的
本研究比较了多种认知领域的教育程度和测试，作为认知储备的替代指标。
方法
参与者为参加纵向老龄化研究的具有不同教育背景、种族和认知能力的老年人。我们研究了教育、基线认知评分以及皮质灰质变化的 MRI 测量值对纵向认知变化的独立和交互影响。
结果
基线情景记忆与认知衰退独立于大脑和人口统计学变量相关，并且调节（减弱）了灰质变化的影响。教育调节（增强）了灰质变化的影响。非记忆认知测量并不能增加解释认知衰退或调节灰质变化效应。
结论
情景记忆作为认知储备的衡量标准，具有很强的结构效度。教育对认知衰退的影响取决于萎缩率，这表明只有当萎缩率较低时，教育才能有效地衡量认知储备。结果表明，情景记忆作为未来认知衰退的预测指标具有临床实用性，并且比其他认知能力或静态替代指标（如教育）更好地代表认知储备的神经基础。
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